A patient's primary care provider has indicated that her symptoms of dyspnea and fatigue related to heart failure are class IV. This classification indicates that she experiences
a. symptoms with any activity or even at rest.
b. symptoms with ordinary physical activity and has a slight limitation of physical activity.
c. no symptoms with ordinary physical activity.
d. symptoms with ordinary physical activity and has a marked limitation of physical activity.
A
The New York Heart Association has developed functional guidelines for classifying patients with congestive heart failure. The classification is based on the person's tolerance to physical activity. Class I: No limitation on physical activity. Ordinary physical activity does not cause fatigue, dyspnea, palpitations, or anginal pain. Class II: Slight limitation of physical activity. No symptoms at rest. Ordinary physical activity results in fatigue, dyspnea, palpitations, or anginal pain. Class III: Marked limitation of physical activity. Usually comfortable at rest. Ordinary physical activity causes fatigue, dyspnea, palpitations, or anginal pain. Class IV (the most severe classification): Inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of angina may be present even at rest. If any physical activity is undertaken, discomfort is increased. The patient described in the question is a class IV; therefore, option "a" is correct. Option "b" relates to class II. Option "c" relates to class I. Option "d" relates to class III.
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